Ashley Wietz Nottebart, PMHNP-BC

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Austin, TX

NPI 1154059780 · NPPES record last updated Aug 11, 2022

Key facts

NPI
1154059780
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
1088487 (TX)
Practice address
5424 W US Hwy 290 Service Rd
Austin, TX 78735
Phone
(512) 430-1130
Fax
(512) 677-6806
NPI assigned
Aug 11, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1088487TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Austin Psychiatry & Wellness PLLC Psychiatric/Mental Health Past
since Nov 19, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1088487 TX Yes

Addresses

Primary practice location

5424 W US Hwy 290 Service Rd
Austin, TX 78735

Mailing address

5424 W US 290 Hwy Service Rd
Austin, TX 78735
Phone (512) 430-1130

Other providers in Austin, TX

All providers in Austin, TX · Psychiatric/Mental Health Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.